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NPI Code Detail

MEDICARE: RADIATION MEDICINE SPECIALISTS OF NORTHEAST PENNSYLVANIA P C

MEDICARE: RADIATION MEDICINE SPECIALISTS OF NORTHEAST PENNSYLVANIA P C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0001XRadiation Oncology PhysicianPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4DN7304OTHERPARR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12072453OTHERPAAETNA USHC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
35170OTHERPAGEISINGER HEALTH PLAN

General Provider Information

NPI Number : 1104804889
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIATION MEDICINE SPECIALISTS OF NORTHEAST PENNSYLVANIA P C
Provider Business Mailing Address
First Line : PO BOX 515490
Second Line :
City : LOS ANGELES
State : CA
Zip : 90051-6790
Country : US
Telephone Number : 310-335-4000
Fax Number :
Provider Business Practice Location Address
First Line : 190 WELLES ST
Second Line :
City : FORTY FORT
State : PA
Zip : 18704-4968
Country : US
Telephone Number : 570-714-8686
Fax Number : 570-714-8666
Authorized Official
Title or Position : PRESIDENT
Name : DR. NORMAN SCHULMAN
Credential : MD
Telephone Number : 570-714-8686
Provider Enumeration Date : 01/04/2006
Last Update Date : 07/21/2022

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1013954007 — ANDREW T TURRISI III MD
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1023050663 — DR. LOUIS R. SIEMINSKI PH.D.
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Directions to “RADIATION MEDICINE SPECIALISTS OF NORTHEAST PENNSYLVANIA P C ” Practice Location

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